Analgesia after upper abdominal surgery with extradural buprenorphine with lidocaine.
OBJECTIVE
To determine whether the continuous low thoracic extradural administration of the same dose of lidocaine at low concentration with a high infusion rate or at high concentration with a low infusion rate in combination with a fixed dose of buprenorphine (0.4 mg.day-1) modifies postoperative pain relief.


METHODS
Twenty-eight patients undergoing elective upper abdominal surgery were randomly allocated to one of two groups to receive lidocaine 2%--buprenorphine at a rate of 6.3 ml.hr-1 (2% group, n = 13) or lidocaine 6%-buprenorphine at a rate of 2.1 ml.hr-1 (6% group, n = 15). During suture of the peritoneum, mepivacaine 2% (8 ml) with 0.1 mg (0.5 ml) buprenorphine was infused extradurally. After extubation, the continuous extradural infusion was initiated. Patients were assessed for the level of analgesia with the 10 cm VAS score at rest and with the Prince Henry Pain Scale (PHPS) at 3, 6, 9, 12, 18, and 24 hr postoperatively.


RESULTS
The visual analogue scale (VAS) scores at rest did not differ between the two groups except at 18 hr after surgery. The Prince Henry Pain Scale (PHPS) scores were not different between the two groups postoperatively.


CONCLUSIONS
There was no difference in analgesia produced by the continuous extradural infusion of lidocaine 2%-buprenorphine at a rate of 6.3 ml.hr-1 and that of lidocaine 6%-buprenorphine at a rate of 2.1 ml.hr-1 following upper abdominal surgery.
Wajima
Z
Z
Department of Anaesthesia, Chiba Hokusoh Hospital, Nippon Medical School, Japan.
Shitara
T
T
Ishikawa
G
G
Inoue
T
T
Ogawa
R
R
D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002763:Cholecystectomy; D004338:Drug Combinations; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007260:Infusion Pumps; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010423:Pentazocine / Q000627:therapeutic use; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004338:Drug Combinations; D002047:Buprenorphine; D008012:Lidocaine; D010423:Pentazocine